Cavernous Sinus Meningioma

A 33-year-old woman reported suffering from diplopia and a progressive visual field defect in the right eye after giving birth 5 months ago. She has been treated with oral steroids 80 mg per day. Her best-corrected visual acuity was 6/20 in the right eye and 6/6 in the left. Intraocular pressures were normal. She could identify 11 plates in the right and 15 plates in the left with the Ishihara test. Anterior segments were normal aside from RAPD that was found in the right pupil. Fundoscopic examination revealed myopic change (Fig. 46.1). Visual field examination revealed peripheral constriction in the right eye (Fig. 46.2). MRI showed an enhanced lesion in the right cavernous sinus, primarily suspected to be an inflammatory pseudotumor and less likely a meningioma (Fig. 46.3). Optic canal decompression was suggested and explained to the patient. The patient decided to continue with oral steroid treatment, and her vision recovered gradually to 6/7.5.